For a lot of couples, the thought of having an outsider come into their relationship to assess problems and intervene can be daunting. But it is often the case that having another, professional opinion is exactly what is needed to bring clarity and provide a fresh perspective on issues that we feel stuck on. Keep reading to learn what to expect from a clinical psychologist and what happens during couples therapy.
What happens during couples therapy
Setting the frame for therapy
For couples therapy to be successful, ongoing sessions are recommended, including both couple sessions and individual sessions for the psychologist to get a grasp on the problems being presented and an idea of how to work through them based on the couple’s and individual’s experiences, feelings and motivations. Then the therapist will share formulations and recommendations about treatment for the couple and how they can move forward with the therapist.
Creating a psychological space
To make a psychological space for couples therapy, psychologists set their expectations to the couple and not the individuals that make it. They listen, allow the couple’s feelings to be expressed (transference), experience those feelings in relation to themselves to interpret the couple’s feelings in a way that they can understand them.
Listening to the unconscious
Psychologists will listen to the issues that the couple presents in a relaxed yet attentive way. While listening to what each individual has to say, they are focusing more on the communication from the couple onto the therapist, both conscious and unconscious communication. It is often more what is not said, such as silences and body language, that the psychologist observes and integrates with what is said to create a broader understanding. They may also interpret information from dreams, fantasy and physical intimacy.
Following the affect
Psychologists are interested in affective moments, or emotional words or gestures, because these come from the unconscious roots of feelings and can tell the psychologist a lot about the couple’s emotional history.
Negative capability is the capacity for a therapist to be in uncertainty and doubt while listening, but without the need to fully understand why something is the way that it is. Rather, psychologists will allow the meaning of the event or feeling to present itself in time. This means that they are respectful of the couple’s sharing and are able to listen with casual curiosity without pressing for meaning or more information.
Transference and countertransference
Transference is when the patient unconsciously directs feelings that they have towards someone else, such as a parent, to their present situation. Psychologists receive transference from the individuals and from the couple as a whole, from their words, nonverbal communication, feelings, emotions and fantasies. Countertransference is where the therapist’s feelings are redirected towards the couple. Countertransference is often unconscious and can be in tune with the couple or it can be discomfort or fantasy that the psychologist will use to work with. Countertransference can be valuable for the therapist to understand how the couple is relating based on unconscious object relations that project from their motivations and experiences.
Interpretation of defense
Psychologists draw from their own experience to interpret the couple’s pattern of defenses, such as denial or distortion of reality. They recognise patterns in the couple’s behaviour and interactions with one another and with the psychologist that are defensive. The psychologist will intervene and try to work out what it is that the couple are defending against, so that they can find the root of the defense.
Confronting basic anxieties
Often individuals keep their basic anxieties out of their consciousness because they seem too intolerable. While they may not realise it, anxieties can hinder their relationships with other people, particularly in romantic relationships. Often these anxieties present themselves to the therapist through the individual’s defenses and their transference, which the therapist can identify and explore. Once these anxieties are named, faced and adapted to, the couple can start to move forward to the next phase of their relationship.
Scharff JS, Scharff DE. Object relations couple therapy. American Journal of Psychotherapy. 1997;51(2):141-73.